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Table 2 Comparison of inpatient diagnostic test indications for community-acquired pneumonia (CAP) across different European medical centres compared with United States [13] and United Kingdom [1] guidelines

From: Comparison between diagnosis and treatment of community-acquired pneumonia in children in various medical centres across Europe with the United States, United Kingdom and the World Health Organization guidelines

Diagnostic test

Guideline

European study

PIDS-IDSA

BTS

Chest radiograph

Yes

Yes

Yes

Complete blood count

Yesa

No

Yes

Acute phase reactants (CRP, serum PCT, ESR)

Yesa,b

No

Yes

Sputum samples for bacteria

Yes

Not specified

Yesc

Tests for Mycoplasma, Chlamydia d

Yes

Yes

Yesc

Tests for respiratory virusesd

Yes

Yes

Yesc

Blood culture

Yes

Yes

Yes

Nasopharyngeal secretions

Not specified

Yes

Yesc

Serum electrolytes

Not specified

Not specified

Yes

Not recommended

Urinary antigen detection for pneumococcus

Diagnostic testing for Chlamydophila pneumoniae

Urinary Antigen detection for pneumococcus

Acute phase reactants

 

Other

Tracheal aspirates for gram stain and culture

Pleural fluid for microscopy, culture and antigen detection

 
  1. With the exception of a chest radiograph, the World Health Organization does not mention use of specific inpatient diagnostic testing and is excluded from the table
  2. PIDS-IDSA Pediatric Infectious Diseases Society and the Infectious Diseases Society of America, BTS British Thoracic Society, ESR erythrocyte sedimentation rate, CRP C-reactive protein, PCT procalcitonin
  3. aDiagnostic test recommended only for those with severe disease
  4. bAcute phase reactants cannot be used as the sole determinant to distinguish between viral and bacterial causes of CAP
  5. cTests recommended in <50 % of medical centres
  6. dSerology, polymerase chain reaction, culturing and other tests are available but no specific test is recommended